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Standardizing Neurological Assessments

Iacono, Laura A.; Wells, Celia; Mann-Finnerty, Kathy

Journal of Neuroscience Nursing: April 2014 - Volume 46 - Issue 2 - p 125–132
doi: 10.1097/JNN.0000000000000035

Evaluation of neurological status is imperative to patient assessment. Multiple assessment tools are readily available for clinicians to diagnose and report changes in neurological condition. Some of these tools include the Glasgow Coma Scale, the National Institutes of Health Stroke Scale, the Canadian Neurological Scale, and the Four Score. Although assessment tools are beneficial to help standardize the assessment and communication of findings, they are at times cumbersome, leaving bedside clinicians with questions concerning which tool is appropriate for a given patient population. This initiative began as a means to standardize assessments and communication for neuroscience patients. As success was met, the project was moved forward locally at our hospital campus and later extended to the entire health system. With the support of the chief of neurology, the neuroscience patient care services director, the stroke coordinator, and the neuroscience clinical educator, three different neurological examinations were developed. They were defined as the Basic Neurological Check, the Coma Neurological Check, and the National Institutes of Health Stroke Scale/Stroke Neurological Check. The neurological examinations would address the assessment needs of patients with acute stroke, general neurosurgery/neurology patients, and patients in coma.

Questions or comments about this article may be directed to Laura A. Iacono, RN MSN CNRN CCRN, at She is a Nurse Manager in the Neurosurgical Intensive Care Unit, North Shore University Hospital, Manhasset, NY.

Celia Wells, RN PhD(c), is the Assistant Director of Nursing Education, North Shore University Hospital, Manhasset, NY.

Kathy Mann-Finnerty, RN MBA MA, is an AVP, Clinical Initiatives, North Shore-Long Island Jewish Health System, New York, NY.

The authors have no financial, consultant, or institutional conflicts of interest to declare.

© 2014 American Association of Neuroscience Nurses